Ectopic parathyroid adenoma with Tc-99m MIBI washout: role of SPECT

The authors present a case of a 71-year-old woman with clinical and biochemical features of primary hyperparathyroidism and a history of right pneumonectomy. An ultrasound scan did not demonstrate any abnormality. A planar Tc-99m methoxyisobutylisonitrile (Tc-99m MIBI) scan showed an area of minimal...

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Published inClinical nuclear medicine Vol. 31; no. 11; p. 713
Main Authors Khan, Muhammad S, Khan, Sameer, Vereb, Marika, Al-Nahhas, Adil M, Dina, Roberto, Lynn, J, Fleming, W
Format Journal Article
LanguageEnglish
Published United States 01.11.2006
Subjects
Adenoma - diagnostic imaging
Adenoma - metabolism
Adenoma - surgery
Aged
Choristoma - diagnostic imaging
Choristoma - metabolism
Female
Humans
Metabolic Clearance Rate
Parathyroid Glands
Parathyroid Neoplasms - diagnostic imaging
Parathyroid Neoplasms - metabolism
Parathyroid Neoplasms - surgery
Radiopharmaceuticals - pharmacokinetics
Technetium Tc 99m Sestamibi - pharmacokinetics
Tomography, Emission-Computed, Single-Photon - methods
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Summary:The authors present a case of a 71-year-old woman with clinical and biochemical features of primary hyperparathyroidism and a history of right pneumonectomy. An ultrasound scan did not demonstrate any abnormality. A planar Tc-99m methoxyisobutylisonitrile (Tc-99m MIBI) scan showed an area of minimally increased uptake within the right hemithorax. However, unlike most adenomas, this demonstrated washout similar to the thyroid at 90 minutes and 3 hours. Subsequent SPECT imaging clearly showed the lesion in the superior right hemithorax. A CT scan and angiogram confirmed the presence of this mass. After surgery, histology confirmed the diagnosis of a parathyroid adenoma. Postoperatively, the calcium and PTH levels returned to normal.
ISSN:0363-9762
DOI:10.1097/01.rlu.0000242692.78833.4f